This study was designed to examine the prospective relations of perceived racial discrimination with allostatic load (AL), along with a possible buffer of the association. A sample of 331 African Americans in the rural South provided assessments of perceived discrimination from ages 16 to 18 years. When youths were 18, caregivers reported parental emotional support, and youths assessed peer emotional support. AL and potential confounder variables were assessed when youths were 20. Latent Growth Mixture Modeling identified two perceived discrimination classes: high and stable and low and increasing. Adolescents in the high and stable class evinced heightened AL even with confounder variables controlled. The racial discrimination to AL link was not significant for young adults who received high emotional support.

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Many African American youth may develop high levels of allostatic load (AL), a measure of physiological wear and tear on the body as a function of developing psychosocial competence under conditions of high SES-related risk. The current study was designed to test hypotheses based on John Henryism theory about such physiological costs. We tested these hypotheses with a representative sample of 489 African American youth living in the rural South. Cumulative SES-related risks and teacher-reported competence were assessed when the youth were 11 to 13 years of age; depressive symptoms, externalizing behavior, and AL were assessed at age 19. The results revealed that rural African American preadolescents who evinced high psychosocial competence under conditions of high cumulative SES-related risk displayed low levels of adjustment problems along with high AL at age 19. These results suggest that, for many rural African Americans, resilience may indeed be only “skin deep.”

The authors examined the relations between adolescent-therapist and mother-therapist therapeutic alliances and dropout in multidimensional family therapy for adolescents who abuse drugs. The authors rated videotapes of family therapy sessions using observational methods to identify therapist-adolescent and therapist-mother alliances in the first 2 therapy sessions. Differences in adolescent and mother alliances in families that dropped out of therapy and families that completed therapy were compared. Results indicate that both adolescent and mother alliances with the therapist discriminated between dropout and completer families. Although no differences were observed between the 2 groups in Session 1, adolescents and mothers in the dropout group demonstrated statistically significantly lower alliance scores in Session 2 than adolescents and parents in the completer group. These findings are consistent with other research that has established a relationship between therapeutic alliance and treatment response.

The health disparities literature identified a common pattern among middle-aged African Americans that includes high rates of chronic disease along with low rates of psychiatric disorders despite exposure to high levels of cumulative SES risk. The current study was designed to test hypotheses about the developmental precursors to this pattern. Hypotheses were tested with a representative sample of 443 African American youths living in the rural South. Cumulative SES risk and protective processes were assessed at 11-13 years; psychological adjustment was assessed at ages 14-18 years; genotyping at the 5-HTTLPR was conducted at age 16 years; and allostatic load (AL) was assessed at age 19 years. A Latent Profile Analysis identified 5 profiles that evinced distinct patterns of SES risk, AL, and psychological adjustment, with 2 relatively large profiles designated as focal profiles: a physical health vulnerability profile characterized by high SES risk/high AL/low adjustment problems, and a resilient profile characterized by high SES risk/low AL/low adjustment problems. The physical health vulnerability profile mirrored the pattern found in the adult health disparities literature. Multinomial logistic regression analyses indicated that carrying an s allele at the 5-HTTLPR and receiving less peer support distinguished the physical health vulnerability profile from the resilient profile. Protective parenting and planful self-regulation distinguished both focal profiles from the other 3 profiles. The results suggest the public health importance of preventive interventions that enhance coping and reduce the effects of stress across childhood and adolescence.

Postmodern models of therapy stress the participation of the clinician in a nonhierarchical, non-objectifying role, and highlight the therapist's embeddedness in the same processes of social construction as are the individual and the family. While much theory has been published in recent years, the actual conduct of a therapy session derived from the premises of postmodernism remains unclear. We investigated how a postmodern therapist manages talk in an actual session. We used textual analysis to examine a couples therapy session conducted by a prominent narrative therapist. Analysis of the talk led to descriptions of the couple's and therapist's agenda, and their interaction. The therapist's agenda is described in terms of "decentering" both the local unfolding narrative and its embeddedness in larger cultural stories. Five conversational practices: matching/self-disclosure, reciprocal editing, turn management to deobjectify, expansion questions, and reversals are examined. These practices inform the deployment of a decentering agenda in this specific text.

The Strong African American Families Program, a universal preventive intervention to deter alcohol use among rural African American adolescents, was evaluated in a cluster-randomized prevention trial. This 7-week family skills training program is based on a contextual model in which intervention effects on youth protective factors lead to changes in alcohol use. African American 11-year-olds and their primary caregivers from 9 rural communities (N = 332 families) were randomly selected for study participation. Communities were randomized to prevention and control conditions. Intent-to-treat analyses indicated that fewer prevention than control adolescents initiated alcohol use; those who did evinced slower increases in use over time. Intervention-induced changes in youth protective factors mediated the effect of group assignment on long-term changes in use.

Objectives. This study was designed to test hypotheses about the prospective association of adolescents’ perceptions of discrimination with increases in substance use and the processes that mediate this association. Methods. African American youths residing in rural Georgia (n = 573; mean age = 16.0 years) provided longitudinal data on their experiences with discrimination, substance use, school engagement, and affiliations with substance-using peers. Results. For male youths, perceived discrimination was significantly related to increases in substance use, and, as hypothesized, this association was mediated by the contributions of perceived discrimination to decreases in school engagement and increases in affiliations with substance-using peers. Analyses also indicated that discrimination influences substance use rather than vice versa. Conclusions. Results are consistent with the hypothesis that high levels of discrimination are linked to increases in substance use for African American male adolescents.